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坏疽性脓皮病的临床特征、治疗及伤口处理:病例系列

Clinical characteristics, treatment, and wound management of pyoderma gangrenosum: A case series.

作者信息

Wang Feixia, Li Lu, Li Weizhen, Ni Xiaobo, Pan Zhe, Ying Lingling, Zhu Mina

机构信息

Nursing department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

PLoS One. 2025 Jun 23;20(6):e0326203. doi: 10.1371/journal.pone.0326203. eCollection 2025.

Abstract

OBJECTIVE

This study aimed to evaluate the clinical characteristics, diagnostic processes, therapeutic approaches, and wound management strategies for patients diagnosed with pyoderma gangrenosum (PG), a rare inflammatory skin condition often resulting in misdiagnosis and treatment delays.

METHODS

A case series was conducted involving patients diagnosed with PG at the author's Hospital, from January 1, 2020 to April 3, 2023. Data on patient demographics, wound characteristics, treatment methodologies, and wound care experiences were collected and analyzed.

RESULTS

The study included nine male patients with a mean age of 48.6 years (median 50 years). All patients were initially misdiagnosed, predominantly as skin infections or cellulitis. Lesions were mainly located on the lower extremities, with ulcerative PG being the most common subtype. Seven patients had skin injuries preceding PG onset. Treatment included systemic glucocorticoids and comprehensive wound care approaches. Three patients required additional interventions, like negative pressure wound therapy. Ultimately, six patients healed, while three died due to severe comorbidities or septic shock.

CONCLUSION

PG is frequently misdiagnosed and often presents as ulcerative lesions triggered by skin injuries. Effective management, including systemic glucocorticoids and focused wound care, can significantly improve patient outcomes.

摘要

目的

本研究旨在评估坏疽性脓皮病(PG)患者的临床特征、诊断过程、治疗方法及伤口管理策略。PG是一种罕见的炎症性皮肤病,常导致误诊和治疗延误。

方法

对2020年1月1日至2023年4月3日在作者所在医院诊断为PG的患者进行病例系列研究。收集并分析患者的人口统计学数据、伤口特征、治疗方法及伤口护理经验。

结果

该研究纳入9例男性患者,平均年龄48.6岁(中位数50岁)。所有患者最初均被误诊,主要误诊为皮肤感染或蜂窝织炎。病变主要位于下肢,溃疡性PG是最常见的亚型。7例患者在PG发病前有皮肤损伤。治疗包括全身使用糖皮质激素和综合伤口护理方法。3例患者需要额外干预,如负压伤口治疗。最终,6例患者治愈,3例因严重合并症或感染性休克死亡。

结论

PG常被误诊,且常表现为由皮肤损伤引发的溃疡性病变。包括全身使用糖皮质激素和针对性伤口护理在内的有效管理可显著改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64f3/12185014/7536316766a1/pone.0326203.g001.jpg

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